1/3. Antigen detection in the diagnosis and management of a patient with probable cerebral aspergillosis treated with voriconazole.This report describes the diagnosis and management of a 16-year-old boy who developed neurological signs and symptoms suggestive of cerebral aspergillosis following a haploidentical bone marrow transplant. A new sandwich enzyme-linked immunosorbent assay (ELISA) for the detection of aspergillus galactomannan circulating antigens (Platelia aspergillus, Sanofi Diagnostic Pasteur, france) was used on serum and cerebrospinal fluid to obtain a presumptive diagnosis and to monitor the course of the disease. Having failed conventional therapy with amphotericin b, the patient received compassionate treatment with voriconazole for a period of 37 days. High levels of voriconazole were observed in both serum and cerebrospinal fluid (CSF), with a trend toward accumulation. After 7 days a marked improvement in the patient's neurological symptoms was noted, and ELISA data indicated a corresponding decrease in aspergillus galactomannan levels in both serum and CSF. Voriconazole was well tolerated, with only transient increases in ALT/AST recorded during therapy. Although the patient survived the acute aspergillus infection, he subsequently died of an unrelated infection.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
2/3. Cerebral aspergillosis in an infant with corticosteroid-resistant nephrotic syndrome.Cerebral aspergillosis is a devastating disease in patients with a compromised immune system. A unique case of a male infant with corticosteroid-resistant nephrotic syndrome complicated by pulmonary and cerebral aspergillosis is described. The patient rapidly developed coma and neurological symptoms and died soon thereafter. central nervous system aspergillosis was diagnosed radiologically and by detection of aspergillus dna and antigen (galactomannan) in blood and cerebrospinal fluid. Moderate immunosuppressive therapy and antifungal phagocytic dysfunction due to nephrotic syndrome per se may have contributed to the occurrence of invasive aspergillosis in our patient. awareness of this serious complication and early application of diagnostic procedures and antifungal therapy may improve the dismal outcome.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
3/3. central nervous system fungal infection--a report of three cases.Fungal infections of the central nervous system in three apparently immunocompetent patients are being reported. Two cases of cerebral aspergillosis presenting as intracranial granulomas such as rhinocerebral and intracranial forms, and one of cryptococcal meningitis could be successfully diagnosed by newer diagnostic modality such as antigen detection techniques. The case with cryptococcal infection had typical neuroimaging feature which helped to suspect the underlying diagnosis. aspergillus galactomannan detection in the cerebrospinal fluid helped in the early diagnosis and appropriate therapy of one patient.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |